Routine inspection·December 16, 2021

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by caregiver. LPA met with Masroor Batla, Administrator and explained the nature of the visit. LPA Martinez accompanied by Administrator began the tour of the inside and outside of the facility. There are four residents in care and there is no active covid-19 case in the facility. Upon entry LPA observed a check in station in the main entry of the facility. LPA observed one resident in living room watching TV and the remainder of resident in their bedrooms. All residents appeared to be clean and well taken care of. LPA observed required department postings, covid-19 precautionary postings throughout the facility. LPA observed the emergency disaster and evacuation plan posted in the facility. There is a 2-day supply of perishables and a 7-day supply of nonperishable food available. Facility has an emergency food supply stored in kitchen and attached garage as well as PPE supply. LPA inspected residents’ bedrooms and appeared to be clean and sanitary. All bedrooms observed to have all required components. Residents bedrooms are one shared and three private bedrooms. One bedroom is empty and used as necessary. All restrooms observed to have supply of soap/sanitizer and appeared to be clean. Facility is taking temperatures daily for residents twice a day and to all visitors upon entry, facility is documenting the results. The facility has a second floor of which no residents are residing in, second floor is inaccessible to residents. LPA toured the outside of the facility and observed seating areas for resident’s enjoyment. There is a gated pool in the back yard, pool is inaccessible to residents. LPA was informed all staff and residents have the covid booster shot. The facility has completed the LIC808 Mitigation Plan, LPA reviewed and approved the plan on today’s visit. LPA signed the hard copy of the plan at the facility for their records. Based on the observation made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator and a copy of this report was provided to the facility.